House Adopts Medicare Drug Benefit

Next Step To Be Debate In Senate

House passage early Friday of Republican legislation was the first of four steps necessary to add a prescription drug benefit to the 37-year-old Medicare program.

The next move will be up to the Senate, where Medicare legislation will face the daunting task of achieving a 60-vote super majority. ``I realize our work is cut out for us, but it is definitely worth the fight,'' said Sen. Christopher J. Dodd, D-Conn.

Senate Majority Leader Thomas A. Daschle, D-S.D., has set aside two weeks in mid-July for the Senate debate. Daschle and Dodd back a plan that would cover more of Medicare beneficiaries' prescription drug costs than the measure the House adopted by a near party-line 221-208 vote.

Chris Hansen, advocacy director for AARP, said the organization's 35 million members continue to hope a prescription drug benefit will become law this year.

``The vote in the House of Representatives to make a voluntary drug benefit a permanent part of Medicare is a step towards that goal,'' Hansen said. But, he added, ``The large gap in coverage that exists in the House bill is a disincentive to enrollment. More funds are needed to close this gap and ensure the viability of the program.''

Under the House Republican bill, beneficiaries would pay a premium estimated at $33 a month and an annual deductible of $250. Beneficiaries would pay 20 percent of drug costs from $250 to $1,000 and 50 percent from $1,000 to $2,000. Once they reach $2,000, beneficiaries would have to pay the full cost of their drugs until they hit the $3,700 annual out-of-pocket limit.

The gap between $2,000 and $3,700 was the subject of repeated Democratic attacks during a nearly six-hour debate that ended at 2:29 a.m. Friday. Still, Rep. Nancy L. Johnson, R-6th District, called the measure ``a giant step forward for seniors in America.''

Johnson, one of the chief architects of the Republican proposal, had a showcase role during the debate. She is in a tight race with Rep. James H. Maloney, D-5th District, as a result of redistricting. Maloney voted for the Republican bill, one of only eight Democrats to break party ranks on the issue. All other members of the Connecticut delegation backed their party's position.

Republicans did not allow Democrats a vote on their alternative. ``The House was left with only one choice, the Republican version -- a grossly inadequate and deeply flawed bill -- or nothing at all,'' Maloney said Friday. Under those circumstances, he said he decided that ``something is better than nothing.''

Bush administration officials hope the House action will put pressure on the Senate to act and to be more receptive to the Republican bill. President Bush originally proposed a $190 billion prescription drug plan. But in recent weeks the administration has embraced the House Republican measure, which would provide $310 billion over the next decade to subsidize seniors' drug purchases and another $40 billion to increase payments to doctors, hospitals, health maintenance organizations and others who provide Medicare services.

Daschle said Friday the House Republican bill is ``a sham.'' The plan he is backing would cost at least $425 billion and would have a lower monthly premium and a lower annual out-of-pocket cap than the House plan.

Two years ago, a House-passed Medicare bill died in the Senate, which was then controlled by Republicans. That could happen again this year, Daschle said Friday. ``The odds are against us, but I don't want to give up.''